According to the Center of Disease Control and Prevention (CDC), as of 2007, approximately 9.5% or 5.4 million children 4-17 years of age have been diagnosed with Attention Deficit Hyperactive-disorder (ADHD). This disorder is one of the most common neurobehavioral disorders in American children. Children with ADHD often have trouble paying attention, sitting still, focusing on tasks, and controlling impulsive behaviors. It is a growing concern and epidemic as rates of diagnosis have continued to increase at an average rate of 5.5% since 2003 (CDC 3). Due to an uncertain biologic cause of the disorder, there have been several speculations as to whether the disorder exists. As numbers rise, several parents, teachers, and researchers also wonder if children are being misdiagnosed and whether pharmaceutical drugs are appropriate sources of treatment. What is ADHD?
ADHD is a relatively new, multifactorial disease with no known scientific cause. In the 2009 book, Medicating Children: ADHD and Pediatric Mental Health, Mayes, Bagwell, and Erkulwater discuss multiple biological causes researchers have discovered up to date. In 1963, Keith Conners and Leon Eisenberg suggested that “problems in inhibitory controlling symptoms….and problems with arousal” cause the symptoms of ADHD. More recently, Barkley attributes the symptoms to “behavioral inhibition [that] involves delaying responses that are likely to be reinforced and protecting this delay so that other self-regulatory functions called executive functions can occur and control responses” (26-27). Mayes, Bagwell, and Erkulwater also discuss neurological studies studying cerebral blood flow and cerebral glucose metabolism. These studies have shown “decreases in blood flow in the prefrontal areas of the brain and also in the connections between these regions and the limbic system in the ADHD group” (27). Some scientists believe that ADHD is caused by “a delay in maturation of the brain” as opposed to an “abnormal brain”, as shown before (28). Most scientists can link this disorder with genetics. ADHD runs in many families and studies have shown distinct correlations among twins. During critical developmental moments, factors such as cigarette-smoking alcohol use during pregnancy, premature delivery and low birth weight have shown linkage to children with the disorder. A small percentage of children may have developed ADHD after a brain injury. Although little scientific research occurs on these ideas, the use of refined sugar and food additives have also been linked to children with ADHD. Studies are being conducted to find correlations between the disorder and environmental factors such as poverty, family chaos, poor parenting skills, and too much television (NIMS 2). Symptoms and Diagnosis
The symptoms for ADHD have been separated into two groups: symptoms of inattention and symptoms of hyperactivity-impulsivity. The Center for Disease Control and Prevention (CDC) have presented the symptoms and diagnosis of ADHD as designated by American Psychiatric Association's Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR). DSM-IV Criteria for ADHD
Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level:
1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities. 2. Often has trouble keeping attention on tasks or play activities. 3. Often does not seem to listen when spoken to directly. 4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions). 5. Often has trouble organizing activities.
6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time...
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